Q: What might happen when the employer's doctor says fully recovered and Social Security approves a disability claim?

A: The standards for "Total Disability" are different for Social Security and Pennsylvania Workers Compensation.

Just because a IME physician opines that you are fully recovered from your work-related injury, does not mean that this Opinion would be accepted by a Workers Compensation Judge, nor does it mean that Social Security Administration will adopt said Opinion with respect to your Claim for Social Security Disability.

As a result of recent regulations, Claimant's Representatives are required to submit all medical evidence to the ALJ in a Social Security Disability Claim, however, the ALJ is able to make credibility determinations and may reject the Opinion of and IME physician if it is not consistent with the rest of the medical evidence.

Assuming you have just undergone an IME wherein the IME physician has found you to be fully recovered, I would anticipate that the Workers Compensation Carrier will be filing a Petition for Termination of your Workers Compensation Benefits and therefore, it is my recommendation that you promptly contact an Attorney who is a Certified Specialist in Pennsylvania workers Compensation Law to discuss your rights and remedies. The initial consultation would be free of charge and most Attorneys will accept your Case on a Contingent Fee Basis.

A: I agree with Richard. While the determination for Social Security Disability is not binding on a Workers' Compensation Judge (WCJ), since they use different standards, the mere fact an IME doctor says you are fully recovered does not mean that you lose. This will ultimately come down to a decision of a WCJ, as to whether the WCJ feels your doctor, or the IME doctor, is more credible. As Richard suggested, I would agree that you need to obtain the services of an attorney certified as a specialist in workers' compensation law, whether my firm or another of the fine attorneys on this board. Good luck with your case!